Provider Demographics
NPI:1205012754
Name:SHERMAN, JONATHAN M (DPM)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:M
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:JON
Other - Middle Name:M
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:60 MARKET ST
Mailing Address - Street 2:202
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-6548
Mailing Address - Country:US
Mailing Address - Phone:301-330-5666
Mailing Address - Fax:301-330-8971
Practice Address - Street 1:60 MARKET ST
Practice Address - Street 2:202
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-6548
Practice Address - Country:US
Practice Address - Phone:301-330-5666
Practice Address - Fax:301-330-8971
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01326213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU82815Medicare UPIN
MDG01262Medicare PIN
MD00B919J62Medicare PIN
MD4835070001Medicare NSC